Archived listing. The details below describe a past opening.
We are looking for a Nursing Audit Specialist to support a health system in Dallas, Texas through a Long-term Contract assignment. This role is ideal for a registered nurse with coding expertise who can evaluate medical records for documentation quality, coding accuracy, compliance alignment, and reimbursement integrity across hospital-based settings. The position will work closely with clinical, coding, and operational partners to identify audit findings, reduce risk, and strengthen documentation and billing practices. This is a 6-12 month contract assignment.
100% REMOTE
Must be licensed RN Must have CCS Certification (Certified Coding Specialist) Must have clinical background
Responsibilities:
- Conduct thorough reviews of inpatient and outpatient medical records to assess clinical appropriateness, completeness of documentation, and accuracy of coded data.
- Examine records for alignment with reimbursement rules, payer expectations, and applicable state and federal compliance standards.
- Identify patterns, discrepancies, and areas of exposure, then translate findings into practical recommendations for process improvement.
- Partner with nursing, coding, clinical documentation, and operational teams to address audit outcomes and support corrective action plans.
- Provide education and feedback to providers and internal stakeholders to improve documentation integrity and coding compliance.
- Evaluate medical necessity and documentation sufficiency using clinical judgment, coding guidance, and regulatory criteria.
- Prepare clear audit summaries, trend analyses, and reporting materials for leadership and relevant business partners.
- Use electronic medical record systems and reporting tools to track audit activity, support analysis, and maintain accurate records of findings.
- Active Registered Nurse credential with experience in hospital or health system environments.
- Certification in coding, auditing, clinical documentation, or health information management is strongly preferred.
- Demonstrated background in coding audits, documentation review, and healthcare compliance evaluation.
- Strong understanding of inpatient and outpatient coding principles, payer requirements, and reimbursement practices.
- Ability to interpret clinical records, coding guidelines, and regulatory standards with a high level of accuracy and critical thinking.
- Experience collaborating with cross-functional healthcare stakeholders, including clinical, coding, and operations teams.
- Proficiency with Epic EMR and Microsoft Excel.
- Exposure to fee billing, risk adjustment, or clinical documentation integrity workflows is a plus.